Matthew R Judah, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

202112 Issued in AR

Practice address

19 E Mountain St
Fayetteville, AR 72701-6067

Phone

(479) 274-0881

NPI assigned

Dec 18, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Matt R Judah Professional name

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cognitive Behavior Therapy Center

  • Psychologist
  • Chesapeake, VA
  • NPI 1861075988
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1497261101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MEMORIAL HALL",
            "address_2": "DEPARTMENT OF PSYCHOLOGICAL SCIENCE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72701",
            "telephone_number": "757-284-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E MOUNTAIN ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016067",
            "telephone_number": "479-274-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDAH",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "202112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATT",
            "last_name": "JUDAH",
            "middle_name": "R",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kathy Quarles Jordan, LCSW
• Shyni Joseph
• Hannah Joslin
• Jon Nathan Jowers, PT
• JTD MD PLLC
• Hunter Judkins, M.D.
• Michael Jueneman, DPT
• Matt Juillerat, DO
• Ashton Brooke Julian, RDN
• Julie Council, LTD

• Clinical Psychologist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.